Preventive and Comprehensive Dental
Mass Advantage has partnered with Dominion National to provide preventive and comprehensive dental services. Mass Advantage contracts with the Dominion PPO network which means all HMO and PPO plan members, have the ability to see dentists in- and out-of-network.
Basic (HMO) | Plus (HMO) | Premiere (PPO) | Extra (PPO) | |
---|---|---|---|---|
|
|
|
|
|
$1,500 annual allowance for comprehensive services |
$2,000 annual allowance for comprehensive services |
$2,000 annual allowance for comprehensive services |
$2,500 annual allowance for comprehensive services |
Basic (HMO) |
---|
|
$1,500 annual allowance for comprehensive services |
Plus (HMO) |
---|
|
$2,000 annual allowance for comprehensive services |
Premiere (PPO) |
---|
|
$2,000 annual allowance for comprehensive services |
Extra (PPO) |
---|
|
$2,500 annual allowance for comprehensive services |
Mass Advantage contracts with the Dominion PPO network. Your 2025 dental benefit coverage is based on using in-network Dominion PPO providers. If you choose to receive treatment from a licensed dentist outside of the Dominion PPO network, the procedures covered under our plan will be reimbursed up to the 2025 maximum benefit limit for your dental coverage (see your Evidence of Coverage for more information). You are responsible for any amounts that exceed your maximum benefit limit for both in-network and out-of-network dental services.
Frequently Asked Questions
Preventive dental includes services like routine exams, cleanings and x-rays. For a full list of covered preventive dental services, please see your Evidence of Coverage (EOC)
Comprehensive dental includes services like periodontics, extractions, restorative services and more. For a full list of covered comprehensive dental services, please see your Evidence of Coverage (EOC).
Yes. We have contracted with the Dominion PPO network which means all HMO and PPO plan members, have the ability to see dentists both in and out of the Dominion PPO network for preventive and comprehensive care.
Preventive and comprehensive benefits are calculated using a Maximum Allowable Charge (MAC). Members are responsible for any difference in amount charged by an out-of-network dentist and the MAC per> procedure. Billing arrangements are made between the member and the out-of-network dentist.
If you receive treatment from an out-of-network dentist, you may be required to make payment in full at the time of service. You will then need to submit a Direct Member Reimbursement Form to receive payment.
Our Member Navigator team is here to help with any benefit coverage or network questions or concerns. Member Navigators are available: (844) 483-1444 (TTY 711) Monday through Friday from 8 am – 5 pm.
Contact
For more information or to find an in-network
dental provider, contact us at (844) 918-0114 HMO or (844) 915-0234 PPO / TTY:711
We’re available October 1 – March 31, 8:00 am – 8:00 pm, 7 days a week;
and, April 1 – September 30, 8:00 am – 8:00 pm, Monday – Friday.